This paper summarizes Professor WANG Yaoxian's experience in treating diabetic kidney disease （DKD） from the perspective of spleen and stomach based on the "internal heat leading to concretions" theory. It is considered that internal heat leading to concretions constitutes the core pathogenesis of DKD， with the spleen and stomach serving as the source of internal heat； therefore， treatment should be based on regulating the spleen and stomach. In the early stage of DKD， dysfunction of the spleen and stomach leads to the initial generation of internal heat. Common syndrome patterns include gastrointestinal heat accumulation and constrained heat in the liver and stomach， for which modified Gegen Qinlian Decoction （葛根芩连汤） can be used to clear heat bind while modified Dachaihu Decoction （大柴胡汤） is used to clear stomach and soothe liver， respectively. In the middle stage of DKD， weakness of the spleen and stomach results in the initial formation of concretions and conglomerations. Common patterns include spleen deficiency with prevalence of dampness and deficiency of both the spleen and kidney. Treatment emphasizes strengthening the spleen and resolving dampness， raising yang and boosting the stomach with modified Shengyang Yiwei Decoction （升阳益胃汤）， or supplementing spleen and boosting kidney， dissipating bind and dispe-ring concretions with modified Shenqi Dihuang Decoction （参芪地黄汤）， respectively. In the late stage of DKD， it is characterized by spleen and stomach depletion， and rampant accumulation of turbidity and toxin， and the common syndrome patterns are damp-turbidity obstruction in the middle jiao （焦） and spleen-kidney yang deficiency. Treatment aims to remove turbidity and harmonize the stomach， or to warm the kidney and strengthen the spleen while elimina-ting turbidity， using modified Dahuang Gancao Decoction（大黄甘草汤） and Jupi Zhuru Decoction （橘皮竹茹汤） or modified Baoyuan Decoction （保元汤） and Lizhong Decoction （理中汤）， respectively. In clinical practice， appropriate formulas and medications are flexibly selected according to specific syndromes.

Objective: To examine the prevalence of e-cigarette use and associated factors among primary and secondary school students in Pudong New Area, Shanghai, and to explore the pathways linking harm perception of e-cigarettes, interpersonal social influence, and attitudes toward e-cigarette use with experimentation behavior, in order to provide scientific basis for further optimizing the prevention and control strategies of e-cigarette among adolescents. Methods: From September to October 2025, a multi stage cluster random sampling method was used to select 5 144 primary and secondary school students aged 8-19 years from 47 primary and secondary schools in Pudong New Area, Shanghai, to conduct an anonymous questionnaire survey. The questionnaire collected information on e-cigarette use, harm perception of e-cigarette, interpersonal social influence, and attitudes toward e-cigarette use. The Chi-square test was applied to analyze the differences in cigarette and e-cigarette use behavior among primary and secondary school students with different demographic characteristics. Structural equation modeling (SEM) was constructed using Mplus 8.3 software, and the bootstrap method was utilized to test the mediating effects. Results: The reported rates of cigarette experimentation, e-cigarette experimentation, and current e-cigarette use among primary and secondary school students were 1.85%, 2.10%, and 0.70%, respectively. Higher reporting rates of e-cigarette experimentation were observed among boys (2.82%), secondary school students aged 16-19 (3.39%), senior high school students (3.05%), and those with weekly pocket money >100 yuan ( 6.11% ) ( χ 2=11.67, 8.61, 8.00, 54.18, all P <0.05). Structural pathway analysis results demonstrated that e-cigarette harm perception positively predicted interpersonal social influence ( β =0.61) and e-cigarette use attitude ( β = 0.53 ), and interpersonal social influence ( β =0.65) and e-cigarette use attitude ( β =0.25) further promoted e-cigarette experimentation behavior among primary and secondary school students (all P <0.01), with interpersonal social influence playing a major mediating role (indirect effect=0.40). Conclusions E-cigarette experimentation behavior among primary and secondary school students in Pudong New Area is jointly influenced by multiple psychosocial factors. Intervention strategies should strengthen interpersonal social factors such as family and peers on the basis of health education, thereby constructing a comprehensive prevention and control strategy for e-cigarette use among primary and secondary school students.

This paper proposes a five-in-one diagnosis and treatment model of "disease-mechanism-syndrome-symptom-method" based on treatment guided by mechanism differentiation. The model consists of five component including disease identification， mechanism differentiation， syndrome differentiation， symptom differentiation， and the formulation of therapeutic strategies. Disease identification refers to the diagnosis of diseases in both traditional Chinese medicine （TCM） and western medicine， aiming to clarify disease progression rules. Mechanism differentiation focuses on grasping the essential characteristics of the disease. Syndrome differentiation emphasizes the stage-specific features of disease evolution. Symptom differentiation highlights the patient's most urgent complaints and suffering. Finally， a comprehensive therapeutic strategy is developed， including internal medication， external applications， and non-pharmacological therapies. The five components of "disease-mechanism-syndrome-symptom-method" are organized in a sequential and progressive manner， forming an integrated whole that spans the entire diagnostic and therapeutic process.Disease identification represents the starting point， while mechanism differentiation serves as the core， and therapeutic formulation is the endpoint of the model， with the aim of achieving more precise treatment and improving clinical efficacy.

This paper proposes a five-in-one diagnosis and treatment model of "disease-mechanism-syndrome-symptom-method" based on treatment guided by mechanism differentiation. The model consists of five component including disease identification， mechanism differentiation， syndrome differentiation， symptom differentiation， and the formulation of therapeutic strategies. Disease identification refers to the diagnosis of diseases in both traditional Chinese medicine （TCM） and western medicine， aiming to clarify disease progression rules. Mechanism differentiation focuses on grasping the essential characteristics of the disease. Syndrome differentiation emphasizes the stage-specific features of disease evolution. Symptom differentiation highlights the patient's most urgent complaints and suffering. Finally， a comprehensive therapeutic strategy is developed， including internal medication， external applications， and non-pharmacological therapies. The five components of "disease-mechanism-syndrome-symptom-method" are organized in a sequential and progressive manner， forming an integrated whole that spans the entire diagnostic and therapeutic process.Disease identification represents the starting point， while mechanism differentiation serves as the core， and therapeutic formulation is the endpoint of the model， with the aim of achieving more precise treatment and improving clinical efficacy.

Objective: To investigate independent risk factors for lower extremity amputation (LEA) in hospitalized patients with diabetic foot ulcers ( DFUs) . Methods: A multicenter retrospective analysis was conducted on the clinical data of 329 DFUs hospitalized patients with diabetic foot ulcers from four general hospitals across the na⁃tion. A multivariate Logistic regression model was constructed , and prediction analysis was performed using R 4. 2. 1 . The discriminative ability of the model was assessed using receiver operating characteristic curves , while calibration accuracy and clinical applicability were evaluated via calibration curves and decision curve analysis. Results : The study revealed that patients with higher education backgrounds showed lower disease severity (Wagnergrade) (Z = - 4. 331 , P < 0. 05) . A history of amputation , pre⁃existing lower extremity vascular disease , abnormal dorsalis pedis artery pulsation , and a history of coronary heart disease were significantly associated with the severity of DFUs , resulting in higher Wagner scores (P < 0. 05) . In the amputation prognosis analysis , prolonged duration of diabetes and elevated white blood cell count were positively correlated with amputation risk ( both P < 0. 01) .Multivariable regression identified non⁃higher education , low hemoglobin levels , decreased total cholesterol , and abnormally elevated platelet counts as independent risk factors for high Wagner grades ( ≥ grade 3 ) ( all P <0. 05) . The integrated predictive model incorporating these factors demonstrated strong discriminative performance ,with an area under curve of 0. 880 (95% CI: 0. 801 - 0. 960) . The calibration curve slope approached the ideal value , and decision curve analysis confirmed the model ′s clinical net benefit within a threshold probability range of 10% - 65% . Conclusion Lower education level , poor baseline nutritional status , infection , hypercoagulability ,and underlying vascular diseases collectively constitute key factors contributing to elevated amputation risk in DFUs patients. The developed predictive model exhibits high accuracy and may assist clinicians in formulating individual⁃ized intervention strategies.

The paper introduces Professor FAN Gangqi's clinical experience in treatment of migraine. Regarding the syndrome/pattern differentiation of TCM, a four-approach framework is established, identifying the nature of illness, analyzing the syndrome/pattern and pathogenesis, determining the stage of illness, and identifying body constitution. In treatment, the principle of treatment is determined in line with syndrome/pattern differentiation, so as to ensure the therapeutic effect by means of "four dimensions". The acupuncture regimens are formulated in terms of the illness stages, "strong needling stimulation in acute stage for analgesia, and needle retaining in chronic stage for long-term effect". "Focusing on neuovascular pathway" is the effective approach to treatment of migraine with acupuncture and moxiubstion. The clinical holistic model by combining acupuncture with medication is advocated because that "the single acupuncture is weak in therapeutic effect, but with medication combined, the effect is enhanced". The different acupuncture techniques are provided comprehensively in treatment of migraine such as horizontal and row-like needling, collateral needling at Taiyang (EX-HN5), acupuncture at Sankong (Yuyao [EX-HN4], Sibai [ST2] and Jiachengjiang [Extra]), acupoint injection at Tianyou (TE16) and Renying (ST9), and acupoint embedding therapy at Fengchi (GB20).
Humans ; Migraine Disorders/diagnosis* ; Acupuncture Therapy ; Moxibustion ; Acupuncture Points ; Female ; Male ; Adult

Diabetic kidney disease （DKD） is one of the main causes of chronic kidney disease. Both traditional Chinese medicine （TCM） and western medicine have their own advantages in the prevention and treatment of DKD， but there are also many difficulties. By analysis of the difficulties faced by TCM and western medicine in the differentiation and treatment of DKD， based on the theory of "miniature masses in the renal collaterals"， combined with long-term clinical practice， "internal heat leading to mass" is proposed as the core pathogenesis of DKD. Therefore， a trinity model of "disease-syndrome-symptom" for differentiation and treatment of DKD based on the core pathogenesis has been proposed. This model highlights the status of the core pathogenesis of "internal heat leading to mass" in DKD， and conducts a three-dimensional identification from the perspectives of disease， syndrome and symptom， so as to inspire clinical practice.

Objective To develop the Perceived Spouse Support Scale for pregnant women in the second and third trimester of pregnancy and test its reliability and validity,so as to provide an effective tool for assessing the perceived spouse support level of pregnant women.Methods With social support theory as the theoretical framework,the questionnaire item pool was initially constructed through literature review and semi-structured interview,and the initial questionnaire was formed through expert correspondence and cognitive interview.From April to November 2023,570 pregnant women in the second and third trimester of pregnancy were selected by random sampling method for investigation,item analysis and reliability and validity test of the scale.Results Eventually 558 pregnant women completed the suivey.The Perceived Spouse Support Scale for pregnant women in the second and third trimesters contained 22 items,including instrumental support,informational support and emotional support.The Cronbach's α coefficient of the scale was 0.867;the split-half reliability was 0.793;the retest reliability was 0.965;the content validity index was 0.980.The cumulative variance contribution rate of the 3 common factors was 54.138％.Confirmatory factor analysis suggested that the model fit well.Conclusion The Perceived Spouse Support Scale has good reliability and validity,and it can be used as an evaluation tool for spouse support level of pregnant women.

Acupuncture and moxibustion therapy is a kind of treatment and health care method with original advantages of China.With the rapid development of epigenetics and systems biology technology,non-coding RNA(ncRNA)related research has made continuous breakthroughs in the field of acupuncture and moxibustion.This article collected the basic research literature on acupuncture and moxibustion related to ncRNA,and reviewed the research subsystems related to microRNA(miRNA),long chain non coding RNA(lncRNA)and circular RNA(circRNA).NcRNAs are widely involved in the growth,development and reproduction of the organism,as well as in the occurrence and development of various diseases,which fits with the multi-layer,multi-pathway and multi-target action network of acupuncture and moxibustion therapy.Taking ncRNAs as the breakthrough point to explore the mechanism of acupuncture and moxibustion in depth is not only conducive to promoting the exploration of new targets of acupuncture and moxibustion effect,but also can reveal the epigenetic regulation axis of acupuncture and moxibustion effect molecules,and provide ideas and methods for clinical diagnosis and treatment of diseases and evaluation of efficacy.

Objective To explore the change trend and related mechanism of resting metabolic rate induced by corticosterone in mice,and observe the intervention effects of Zhibai Dihuang Pill and Jinkui Shenqi pill.Methods Sixty-four mice were randomly divided into short-term and long-term groups,and each group was randomly divided into four groups.Mice in CORT group,ZBDH group and JKSQ group were given sterile drinking water containing corticosterone,and mice in Ctrl group were given sterile drinking water containing 1%anhydrous ethanol.Mice in ZBDH group and JKSQ group were given Chinese medicine by gavage.RMR of mice in each group was dynamically monitored during modeling and Chinese medicine intervention.The morphology of mitochondria in liver and muscle were observed by transmission electron microscope.The TR expression level in liver and muscle tissues of each group was observed by immunofluorescence,and MDA and ATP levels were detected in liver and muscle tissues of each group.levels of ACTH,TSH,INS,T3,T4,FT3,FT4,8-OHdG,FGF-21,GDF-15,L-lactic acid and pyruvic acid in serum were also detected.Results Compared with Ctrl group,the mitochondrial morphology of liver and muscle tissues in CORT group was damaged,and the expression of TR was decreased.In short-term(Day 8),RMR,ATP in liver,serum T4,ACTH and INS levels were significantly increased in the CORT group,while serum FGF-21,TSH levels and MDA in liver were significantly decreased.In long term(Day 56),RMR,serum 8-OhdG,INS,and ATP in liver and muscle were significantly decreased in the CORT group,serum FGF-21,GDF-15,T3,T4,FT3,FT4,MDA in liver and muscle were significantly increased.Compared with CORT group,in short term,RMR,serum L(+)-lactate in ZBDH group were significantly decreased,while serum 8-OHdG and the expression of TRα in muscle were significantly increased.In JKSQ group,the mitochondrial morphology of muscle tissue was improved,the expression of TRα and serum FGF-21 were significantly increased,while serum L(+)-lactic acid,FT4 and ATP in liver were significantly decreased.In long term,serum FGF-21 was significantly lower in ZBDH group,and in JKSQ group,RMR,ATP in liver tissue and TRα expression in muscle were significantly increased,while the levels of FGF-21,GDF-15,T3,FT4 in serum and MDA in muscle tissue were significantly decreased.Conclusion CORT induced RMR to increase first and then decrease with the intervention time.In the short term,Zhibai Dihuang Pill significantly decreased RMR in mice,while in the long term,Jinkui Shenqi Pill significantly increased RMR.The mechanism may be related to mitochondrial injury,thyroxine secretion and thyroxine receptor expression.